Key Points The "Annual Report to the Nation on the Status of Cancer, 1975-2000" provides an update on cancer mortality (death rates), incidence rates (new cases), and trends in the United States. Overall, cancer death rates (for men and women combined) were stable from 1998 through 2000 - that is, rates neither increased nor decreased. Before this, death rates increased through 1990, stabilized through 1994, and declined from 1994 through 1998. Cancer registries routinely take two to three years to compile their current cancer statistics. An additional one to two years may be required to revise the incidence data on certain cancers - such as melanoma and prostate and breast cancers - particularly when they are diagnosed in out-patient settings.

The Purpose of This Report

The "Annual Report to the Nation on the Status of Cancer, 1975-2000" provides an update on cancer mortality (death rates), incidence rates (new cases), and trends in the United States. It also includes data that can be used to develop cancer control plans and programs at the state and local levels. The report is issued annually by the Centers for Disease Control and Prevention (CDC), the American Cancer Society (ACS), the National Cancer Institute (NCI), which is part of the National Institutes of Health, and the North American Association of Central Cancer Registries (NAACCR).

Report highlights

•   Overall, cancer death rates (for men and women combined) were stable from 1998 through 2000 - that is, rates neither increased nor decreased. Before this, death rates increased through 1990, stabilized through 1994, and declined from 1994 through 1998. Throughout the late 1990s, trends for women stabilized, while death rates for men continued to decline.

•   Cancer incidence rates for all cancer types combined increased from the mid-1970s through 1992, but declined from 1992 through 1995, and then stabilized (a non-significant increase) from 1995 through 2000. Increases in incidence rates in breast cancer and prostate cancer offset long-term decreases in lung cancer in men.

•   The report notes a growing difference in death rates between white and black populations for colorectal and breast cancers. By 2000, death rates for these cancers in whites were substantially lower than those in blacks, an indication that black men and women may not have experienced the same benefits from screening and/or treatment as white men and women. These patterns signal that disparities in deaths from some cancers are increasing and that new methods are needed to disseminate advances in prevention, screening and treatment services to all segments of the population.

Rates for the Four Leading Types of Cancer

The following top four cancers represent more than half of all cancer cases:

•   Lung Cancer – death rates among white and black men declined throughout the 1990s, while the rate of increase in deaths among women slowed during the same period, reflecting reductions in tobacco smoking. Lung cancer is the leading cause of cancer death in men and women in the United States.

•   Colorectal Cancer – death rates have been declining for both white and black men and women beginning in the 1970s, with steeper declines beginning in the mid-1980s. However, larger decreases in death rates were observed among white men and women than among black men and women, an indication that black men and women may not have experienced the same benefits from screening and treatment as white men and women. Meanwhile, incidence rates stabilized beginning in 1996 for all men and women.

•   Breast Cancer – death rates continue to fall despite a gradual, long-term increase in incidence rates. Decreasing breast cancer death rates and increasing incidence rates during the 1990s have been attributed, in part, to increased use of mammography screening and the availability of improved therapies. However, death rates for white women are substantially lower than those for black women, an indication that black women may not have experienced the same benefits from screening and treatment as white women.

•   Prostate Cancer – death rates have been declining since 1994, while incidence rates have been rising since 1995, with a 3.0 percent per year increase in incidence in white men and a 2.3 percent per year increase in black men. The reason for the recent increase is not clear. Prostate cancer incidence rates increased throughout the 1970s and early 1980s. Clarification of the risks and benefits of prostate specific antigen (PSA) screening, including potential impact on mortality, awaits the conclusion of two randomized clinical trials now in progress.

Sources of Data Used in This Report

   •   CDC's National Program of Cancer Registries (NPCR)

   •   NCI's Surveillance, Epidemiology, and End Results (SEER) Program

   •   CDC's Behavioral Risk Factor Surveillance System (BRFSS)

   •   CDC's National Vital Statistics System

   •   NAACCR's evaluation and publication of registry data

Years of Data Included in This Report

The report covers cancer incidence and mortality data over two time periods:
   •   Data considered current for this report are from 1996 through 2000, and
   •   Data from 1975 through 2000 were chosen to represent the best perspective on long-term trends in cancer incidence and death rates.

Data Analysis Process

Cancer registries routinely take two to three years to compile their current cancer statistics. An additional one to two years may be required to revise the incidence data on certain cancers - such as melanoma and prostate and breast cancers - particularly when they are diagnosed in out-patient settings. Cancer registries continue to update incidence rates to include these cases. Using a statistical method to adjust for delays in reporting, this report is the first to present analyses of long-term trends in cancer incidence rates with and without adjustment for such reporting delays. These delay-adjusted incidence rates provide the basis for a potentially more accurate assessment of rates and trends, especially for the most recent years. It is now possible to adjust site-specific and all cancers-combined incidence rates to correct for expected reporting delays.

Where to Find the Report

The report is published in the Sept. 3, 2003, issue of the Journal of the National Cancer Institute (Vol. 95 No. 17, pages 1276-1299). The authors of this year's report are Hannah K. Weir, Ph.D. (CDC), Michael J. Thun, M.D. (ACS), Benjamin F. Hankey, Sc.D. (NCI), Lynn A.G. Ries, M.S. (NCI), Holly L. Howe, Ph.D. (NAACCR), Phyllis A. Wingo, Ph.D. (CDC), Ahmedin Jemal, Ph.D. (ACS), Elizabeth Ward, Ph.D. (ACS), Robert N. Anderson, Ph.D. (CDC), and Brenda K. Edwards, Ph.D. (NCI).

Where to Find Additional Information

Additional background on this report can be found at:
http://www.cancer.gov/newscenter/pressreleases/2003ReportRelease
http://www.cancer.gov/newscenter/pressreleases/2003ReportQandA

Resources

For more information, visit the following Web sites:
ACS: http://www.cancer.org
Cancer Control PLANET: http://cancercontrolplanet.cancer.gov
CDC (Division of Cancer Prevention and Control): http://www.cdc.gov/cancer
CDC (National Center for Health Statistics' mortality report):
http://www.cdc.gov/cancer
NAACCR: http://www.naaccr.org
NCI: http://www.cancer.gov and the SEER Homepage: http://www.seer.cancer.gov. This site contains all data points for graphs in the manuscript, as well as supplementary data and charts. Click on the icon "1975-2000 Report to the Nation."